Field of the Invention
This application relates generally to devices and methods for delivery of therapeutic agents to a patient, and more specifically to delivery of therapeutic agents by an implanted device.
Description of the Related Art
Medical treatment often requires administration of a therapeutic agent (e.g., medicament, drugs) to a particular part of the body. Intravenous injection has long been a mainstay in medical practice to deliver drugs systemically. Some maladies, however, requires administration of drugs to anatomical regions or portions to which access is more difficult to achieve.
Eyes are a prime example of anatomical regions in which access is constrained. Ocular pathologies such as diabetic retinopathy and macular degeneration are best treated by administration of drugs to the vitreous humor, which has no fluid communication with the vasculature. Such administration not only delivers drug directly to where it is needed, but also importantly minimizes the exposure of the rest of the body to the drug and therefore to its inevitable side effects.
Injection into the patient's body (e.g., into the vitreous humor of the eye), while medically feasible, delivers a bolus of drug. Many times, however, administration of a bolus of drug is undesirable. For example, drugs often have concentration-dependent side effects that limit the maximum concentration optimally administered to the body. Certain drugs exert their therapeutic action only when their concentration exceeds a threshold value for a given period. For such drugs, the exponential decay in concentration with time of a bolus injection would necessitate repeated injections to maintain the desired drug concentration in the body. Repeated injections not only entail the expense and inconvenience of repeated office visits, but also the unpleasantness of the injections themselves. In addition, with regard to intraocular treatments, repeated injections increase the risk of damage to the eye through infection, hemorrhage, or retinal detachment.
These problems are particularly severe in the case of chronic ailments that require long-term administration of a drug either for treatment and/or for prophylactic maintenance. Other chronic diseases, such as diabetes, are now treated by devices that gradually deliver therapeutic medicaments over time, avoiding or at least reducing the “sawtooth” pattern associated with repeated administration of boluses.